We posted on the AAP's proposal on May 6th. Immediately, we saw a slew of commenters and bloggers who disagreed with the conclusion that a "ritual nick" is a dangerous concession to a practice that has violent and misogynistic roots. Many saw the logic in the AAP's decision, and agreed with their argument that if a "ritual nick" (a small cut to the clitoris) of a small girl can protect them from further harm (i.e. more extensive cutting), then doctors have good reason to engage in the less extreme form of genital mutilation. This lesser-of-two-evils argument justifies a practice that has been condemned by the U.S. government, a practice that is illegal within our borders. We have recently taken steps to ensure that no girls will be brought beyond U.S. borders to undergo the procedure - thanks to senators Joe Crowley and Mary Bono Mack and an excellent piece of journalism from Salon - but still, some were willing to accept the AAP's statement that they were opposed to genital "cutting," as they have decided to term it, except when, you know, they're not. Although the AAP did not suggest we make FGM legal in America, they have proposed doctors be allowed, even encouraged, to participate in the tradition by "pricking" the clitoris with a needle, because, hey, if you can't beat 'em, join 'em, right?

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In a slightly less flippant article, Ayaan Hirsi Ali - author of the autobiography Infidel and survivor of FGM - speaks out against the AAP's proposal to allow a "ritual pinprick." She describes the four different levels of female "circumcision," beginning with the harmless-sounding "nick:"

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To give you an idea of what that means, visualize a preteen girl held down by adults. Her clitoris is tweaked so that the circumcizer can hold it between her forefinger and her thumb. Then she takes a needle and pierces it using enough force for it to go into the peak of the clitoris. As soon as it bleeds, the parents and others attending the ceremony cheer, the girl is comforted and the celebrations follow.

There is a more sinister meaning to the word "nick" if you consider the fact that in some cases it means to cut off the peak of the clitoris. Proponents compare "nicking" to the ritual of boy circumcision. But in the case of the boys, it is the foreskin that is all or partly removed and not a part of the penis head. In the case of the girls, the clitoris is actually mutilated.

The AAP has suggested that U.S. lawmakers allow doctors to engage in this practice in order to prevent girls from being forced to undergo any of the other three forms of FGM. In the second form, part of the clitoris is removed and the opening of the vagina is sewn together (infibulation). The third form includes the removal of the inner labia. The final, and most extreme variation on the tradition, involves removing the entire clitoris and the inner and outer labia, followed by scraping the inner walls of the vagina until they bleed. The entire orifice is then bound together, leaving only two small openings "roughly equal to the diameter of a matchstick" for urination and menstruation. This results in a thick band of scar tissue, which is difficult to penetrate, thus making sex an incredibly painful ordeal and giving birth an extremely dangerous process.

While one might think that the first version of FGM has little to do with the last, all four variations stem from the same logic. Hirsi Ali suggests we "think of it as a genital burqa, designed to control female sexuality." Even the "ritual nick" reveals a deeply-rooted fear and disgust for female sexuality. Although the AAP is trying to protect girls from even worse harm, by allowing doctors to engage in any form of mutilation, they are sending the message to families that some cutting is acceptable, that there is some value and meaning to the tradition.

Perhaps more importantly, there is no guarantee that providing a safe space for the "ritual nick" will stop parents from later having their daughters infibulated. CNN reports that there is still a very real pressure in immigrant communities to continue the tradition of genital cutting. One parent, who decided not to mutilate her daughter, recalls being accused of "[acting] like an American" and "disrespecting" the culture. However, a doctor-approved pinprick will not make this kind of thinking disappear - nor will it keep parents from trying to control their children's sexuality through violence and force. While there is no easy way to eradicate something as deeply ingrained as the misogynist fear of female sexuality, allowing doctors to cut, prick, or nick a girl's genitals will do nothing but set us back. Doctors need to stand with Joe Crowley and Mary Bono Mack and reject FGM, in all variations and forms, entirely.